Download A Measure of Conduct Disorder for Incarcerated

A Measure of Conduct Disorder for Incarcerated Juvenile Offenders
Patrick K. Cook, Barry R. Burkhart, Alejandro A. Lazarte, David J. Pirtle, and Ben Carter
Auburn University, Department of Psychology
Alabama Department of Youth Services
Introduction
Previous Research
• At intake, incarcerated youth report a greater number of symptoms indicative
of mental health problems compared to non-incarcerated youth (e.g., Vaughn,
Howard, Foster, Dayton, & Zelner, 2005, and Abram, Teplin, McClelland &
Dulcan, 2003).
• Of note, symptoms of conduct disorder are reported by a significant portion
of newly incarcerated juveniles. Literature suggests that approximately 40% of
adjudicated adolescents report symptoms suggestive of conduct disorder
(Teplin, Abram, McClelland, Dulcan, and Mericle, 2002).
• Self-report assessment measures (e.g., personality tests, symptom screeners,
etc.) are commonly administered to newly incarcerated adolescents in an attempt
to gain additional information and insight regarding symptoms of
psychopathology.
Instruments (contd.)
• Kiddie-Sads-Present and Lifetime Version (K-SADS-PL; Chambers, 1996).
• Semi-structured diagnostic interview designed to assess current and past
episodes of psychopathology in children and adolescents using DSM-III and
DSM-IV criteria.
• Symptoms
S
are assessedd as clinician
li i i uses probes
b to elicit
li i relevant
l
iinformation
f
i
needed to score each item for current and previous psychopathology.
• Primary diagnoses assessed include: Major Depression, Dysthymia, Mania,
Hypomania, Cyclothymia, Bipolar Disorders, Schizoaffective Disorders,
Schizophrenia, Panic Disorder, Agoraphobia, Separation Anxiety Disorder,
Generalized Anxiety Disorder, Attention Deficit/Hyperactivity Disorder,
Conduct Disorder, Oppositional Defiant Disorder, Enuresis, Encopresis,
Anorexia Nervosa, Bulimia, Substance Abuse, and Post-Traumatic Stress
Disorder.
Goals
• To examine the ability of the Millon Adolescent Clinical Inventory (MACI) to
identify symptoms of conduct disorder for incarcerated adolescents.
• To assess the concurrent validityy of the MACI as a measure of conduct
disorder when compared with clinician ratings of conduct disorder as measured
by the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL).
• To contribute to the limited literature regarding levels of psychopathology (e.g.,
disruptive behavior disorders) for juvenile offenders.
Discussion
Method
• Juvenile youth-offenders incarcerated at an Alabama Department of Youth
Services correctional facility.
• N= 625, Mean Age = 15.66 years old (SD = 1.56 years)
• Juvenile offenders incarcerated primarily on following charges: Assault, Theft
of Property, Burglary, Disorderly Conduct, Drug Offenses, Rape (attempted),
Sexual Abuse (attempted), or Sexual Assault (attempted).
• Demographic Breakdown: Caucasian (55.9%), African-Americans (40.9%), and
“Other” (3.2%).
Instruments
• The MACI was designed to measure unique psychosocial concerns
concerns, personality
styles, and clinical symptoms via a true-false format.
• The normative sample is comprised of male and female adolescents selected
from a variety of mental health settings including outpatient mental health
clinics, private practice settings, inpatient psychiatric and general medical units,
and residential treatment units.
Results
• Results revealed a significant overall effect (-2*Log Likelihood = 707.85), χ2 (611) =
123.06, p < .001.
• The predictor variables produced a significant reduction in the log likelihood function.
• Results
R l iindicated
di
d that
h the
h U
Unruly
l scale
l contributed
ib d alone
l
to a significant
i ifi
rating
i off
conduct disorder as measured by the K-SADS-PL, Wald = 12.54, p < .001, as the
remaining MACI scales (e.g., Forceful, Oppositional, Social Insensitivity, and Delinquent
Predisposition) were non-significant.
• For each additional base rate point on the UnrulyScale, the odds ratio of being
classified as conduct disorder according to the K-SADS-PL increases by 3.5%.
• The Hosmer and Lemeshow goodness of fit test indicated that the model fits the data
and that 69.6% of cases were correctly classified, χ2 (8) = 9.07, p = .34.
• This investigation examined the ability of selected MACI scales to assess for a rating
of conduct disorder as measured by the K-SADS-PL for incarcerated juvenile
offenders.
• The MACI Unrulyy scale was the onlyy significant
g
predictor
p
of conduct disorder based
on K-SADS-PL ratings.
• These results suggest that additional clinical attention is warranted for those
individuals who endorse items on the MACI unruly scale given its item content as well
as its meaningful relationship to a significant rating of conduct disorder as measured by
the K-SADS-PL.
• Relatively weaker concurrent validity was measured between the MACI Forceful,
Oppositional Social Insensitivity,
Oppositional,
Insensitivity and Delinquent Predisposition scales and a significant
rating of conduct disorder on the K-SADS-PL.
P i i
Participants
• Millon Adolescent Clinical Inventory (MACI; Millon 1993).
• The MACI is a 160-item, self-report inventory specifically targeted to assess
troubled adolescents.
Procedure
• Participants completed the MACI and K-SADS-PL after an initial facility orientation
period of approximately 10 days.
• Undergraduate research assistants orally administered the MACI as a component of
an assessment battery comprised of self-report measures while graduate student
cclinicians
c a s completed
co p eted the
t e K-SADS-PL
K S DS P interview
te v ew with
w t students.
stude ts.
• MACI item responses were scored via computer scoring software and entered into a
database for analysis.
Sample of Selected MACI Items:
• I’ve never done anything for which I could have been arrested.
q
• I’ve never been called a jjuvenile delinquent.
• I don’t see anything wrong with using others to get what I want.
• I’m no different from lots of kids who steal things now and then.
• Too many rules get in the way of my doing what I want.
• I do what I want without worrying about its effect on others.
Future Directions:
• Examine specific MACI items and their ability to predict a significant rating of
conduct disorder on the K-SADS-PL.
• Examine additional MACI scales and their concurrent validity with K-SADS-PL
ratings
i
off significance.
i ifi
• Continue to add to the limited data regarding psychopathology and juvenile offenders
at time of incarceration and prior to release.
Contact Patrick Cook with any questions at [email protected] or visit the Burkhart
research laboratory webpage to view additional projects examining juvenile offenders at
www.auburn.edu/~burkhbr